FAQs About Certain Provisions In PPACA Now Available

The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury in February issued a list of frequently asked questions (FAQs) regarding automatic enrollment, employer shared responsibility, and waiting periods under the Patient Protection and Affordable Care Act (PPACA). The FAQs address some of the issues raised in comments ABC submitted last year to the Internal Revenue Service (IRS) and HHS as part of the Employers for Flexibility in Health Care (EFHC) coalition.

The coalition expressed concern in two sets of comments filed in June and October of last year that the employer requirements under PPACA are fundamentally unworkable and ultimately will have to be re-examined through the legislative process. The coalition called special attention to the following issues: the 30 hours per week definition of full-time employee status; the affordability safe harbor for employers; the look-back/stability period safe harbor; the minimum value standard; and the imposition of tax penalties.

EFHC also pointed out the interplay of the employer requirements under the law has significant consequences for employers’ ability to maintain flexible work options and affordable health coverage for their employees. Because the employer requirements are inextricably linked, it is imperative that the administration examine these provisions as a whole when developing regulatory guidance, the coalition stated.

The FAQs include the following clarifications:

DOL’s automatic enrollment guidance will not be ready to take effect by 2014.

Treasury and the IRS intend to issue proposed regulations or other guidance permitting employers to use an employee’s Form W-2 wages (as reported in Box 1) as a safe harbor in determining the affordability of employer coverage.

It is anticipated that Treasury and IRS guidance will allow look-back and stability periods not exceeding 12 months.

Treasury and the IRS intend to issue proposed regulations or other guidance that will address how to determine whether a newly hired employee is a full-time employee (for purposes of section 4980H penalty).

The 90-day waiting period begins when an employee is otherwise eligible for coverage under the terms of the group health plan.

Comments on the FAQs must be submitted by April 9. The FAQs can be found on the IRS website.